Lockdown Day 7

One week down and hopefully only another three to go.

I'm back at work tonight and Jaye, a reader, asked what a typical shift is like for me here normally. So I thought I might do a bit of a 'day in the life of' post.

We work 12 hour shifts here, and there is only one midwife on per shift, except Tuesdays, when we have an obstetrician travel here for an outpatients clinic. So on Tuesdays we have another midwife here during office hours to run the antenatal obstetric clinic. We also usually have an admin staff member here during the week for five hours a day.

We are a small, rural, primary unit. We have around about 200 births a year and this number is increasing. We have two birth rooms, five postnatal rooms and an antenatal clinic room. There is only one midwife on per shift because generally we only need one. If a woman comes in to birth, she will have her community midwife with her to provide her care, and the hospital midwife is the second pair of hands if needed and we always have another hospital midwife on-call just in case.

We pride our self on being whanau (family) friendly. The woman's partner or support person can stay overnight and our visiting hours are usually pretty loose. If women need extra help they can stay for up to a week. And this is the sign on our door that usually greets visitors, I think it sums up just who we are here!

If you want to know more about our little unit and the cool midwives we have, you could watch My Maori Midwife, Season One, Episode 3. The birth is filmed here and Nicole Pihema, the midwife, is pretty awesome!

So it hurts that this is the sign that now greets people. Visitors are not permitted. One support person at the birth only, no children allowed. Women are asked to go home as soon as they are able, and they are asked to stay in their rooms until they leave.

Anyhoo. A typical shift starts with handover, when I get information from the previous midwife about what's been happening, what women are inpatients and what care they will need. This often involves a cup of tea and a chat too, but not so much anymore. It's hard to feel chatty when you are trying to maintain a two metre physical distance.

Once the previous midwife has left, I'll log on to the computer, check myself in on to the relevant computer programs that I will need and scan my emails.  And now I wipe down the keyboard and mouse first.

I have checklists to do, these involve checking that the birth rooms are stocked with all the necessary gear, checking drug expiry dates, sending equipment to the sterilising unit, checking fridge temperatures and other equally exciting tasks. The most unusual thing on the checklist is to remember to feed the fish! (We have a fish tank in our waiting area.)

At some relevant point I'll introduce myself to any women who are on the postnatal ward and we'll organise a plan for what care she'll need that day/night. If there are no inpatients, we still need a midwife here because we never know what will walk through our doors, or when they'll walk through! Patient care usually includes a general wellness check of her and baby for starters and then any or all of: breastfeeding assistance, mothercraft teaching, CPR and safe sleeping education, regular pain relief, wound care, neonatal screening and so on. We can only have normal births here, if women need surgical intervention or secondary care they need to birth in our secondary unit (an hour away), but they often come here for a postnatal stay.

I have cleaning tasks around the ward to do, such as empty the dishwasher, and if there is a birth during the night, we clean the birth room. But during the day we have a cleaner to do all the major cleaning tasks such as floors and bathrooms.

During the day, in normal times, we often have walk-ins. People will come in looking to book with a community midwife, and we provide them with information. We will do antenatal checks or fetal monitoring for the community midwives if they are tied up somewhere else. The community midwives run antenatal clinics here so there it's often busy with women coming and going and lots of midwives meeting and chatting.

Sometimes we get women turning up to birth who haven't bothered to get a midwife. Or they are on holiday. Recently I had a woman turn up out of the blue, visiting the area, about five months along and bleeding heavily. So we deal with emergency stuff too.

Tonight, I have a few extra tasks. I have personal protective equipment (PPE) packages to make up to give to the community midwives. The number of homebirths have increased in light of the covid-19 pandemic and midwives are advised to wear PPE for the second and third stage of births for even asymptomatic women (the pushing and birth bit and the placenta bit, generally the messy and heavy breathing bits) so PPE usage is increasing dramatically.

I also have about a billion extra emails to read on new protocols, covid updates and morale boosting emails from management. I feel for the frontline clinical staff in the 'red zones', it must be even more stressful for them.

And I have extra cleaning to do - lots of surface wiping to be done every shift now.

But we are here, and we are ready and waiting, and we will not turn anyone away.